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Hormonal disorders
PCOS (polyendocrine metabolic ovarian syndrome) and hirsutism
Short answer
Polycystic ovary syndrome (PCOS) is one of the main hormonal problems that cause infertility in women. Recently its name was changed: the new name is polyendocrine metabolic ovarian syndrome (PMOS) (video). Two of three findings are enough for the diagnosis: excess androgens (male hormones), many cysts in the ovaries, and an ovulation disorder. The goal of treatment is not only to resolve infertility. It is also necessary to prevent future cardiovascular risk and metabolic diseases such as type 2 diabetes (video).
General information
- Symptoms (by cause):
- Excess androgens: hirsutism (excess hair growth), acne, excess body fat, male-pattern hair loss in the forehead area (alopecia).
- Ovarian cysts: often found on ultrasound and cause no clinical symptoms.
- Ovulation disorder: periods that come at intervals shorter than 3 weeks or longer than 5 weeks; bleeding that lasts longer or shorter than 3–7 days; no periods for a long time.
- Skin signs. Acne, darkening of the skin and increased hair growth in women are often linked to endocrine causes. If you have any of these, endocrine testing is recommended. These signs often come from PMOS (video).
- Diagnosis. It is made on the basis of complaints and laboratory and instrumental tests. It has to be distinguished from diseases of the adrenal glands, the thyroid and other endocrine glands, and also from obesity. That is why the diagnosis should be made by an endocrinologist. The doctor's note: “Its examination and treatment are very multifaceted. When it comes to diagnosis, a collective decision is the best approach.”
- Treatment. Depending on the cause, contraceptives, anti-androgen medicines and drugs that improve insulin sensitivity are used. In overweight patients, losing weight itself is largely effective in the treatment of PCOS. “In its treatment, not only medicines but also a healthy lifestyle plays a very big role.”
- Hirsutism (male-pattern hair growth in women).
- It is excessive growth and thickening of hair in places where there is normally no hair (face, chest, hips, back, etc.). These areas are under the influence of androgens.
- It is not just a cosmetic problem: in most cases, it is a hormonal disorder involving excess androgens.
- Causes: PCOS, insulin resistance, congenital adrenal hyperplasia, tumors of the ovaries and adrenal glands, hypothyroidism, certain medications, idiopathic (cause unknown) cases.
- If, along with the hair growth, periods are late or irregular, acne on the face has increased, the voice has become deeper or hair is falling out, see an endocrinologist.
- Assessment: the endocrinologist uses the modified Ferriman–Gallwey scale. A score of 8 or more is considered hirsutism, and treatment is started. Superficial hair growth must not be confused with hirsutism.
- About laser: in people who go for laser without seeing an endocrinologist, there is no effect because the cause has not been corrected. “Constantly removing the hair does not solve the root of the problem. First the cause must be found, then treatment, and if needed, aesthetic care with laser or epilation.”
In the doctor's practice
a hormonal cause was found in a patient who came in with facial hair growth, and treatment was started. The photo in the post was taken with the patient's permission. The doctor gave a talk at Labstyle Hospital on “Endocrine infertility.”
Q&A
Why was the name of PCOS changed?
Recently, the name of polycystic ovary syndrome was changed: the new name is polyendocrine metabolic ovarian syndrome (PMOS). The name shows that the disease is not related to the ovaries alone but involves the hormonal and metabolic systems (video).
Is treatment for PCOS only for getting pregnant?
No. The goal of treatment is also to prevent future metabolic disorders and cardiovascular risk (video).
Is laser removal of facial hair enough?
No. Without correcting the cause, there is no effect. The endocrine cause must first be investigated and treated; laser and epilation can be done after that as aesthetic care.
The doctor’s videos
The videos are in Azerbaijani.
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